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Author: Poppy E. Deviany Publisher: ISBN: Category : Languages : en Pages : 106
Book Description
Lung cancer is the second most commonly diagnosed cancer and the leading cause of cancer mortality of both genders in the United States. A recent report suggests that the relative five-year survival rate of lung cancer is only 18%. Studies indicate many factors are associated with the survival of lung cancer patients, including age at diagnosis. It is widely known as a disease of older people, but the literature shows a substantial number of young people have been diagnosed with lung cancer. The literature also indicates that the refusal of recommended treatment contributes to cancer-related death and poorer survival. The objectives of this dissertation were to estimate the survival of lung cancer patients, examine the effect of treatment refusal on survival, and investigate factors associated with treatment refusal. To address these objectives, we conducted our analyses using two large cancer databases: the Veterans Affairs Central Cancer Registry and the National Cancer Database. We performed statistical data analyses using logistic regression, the Kaplan–Meier survival estimator, and Cox regression (proportional hazards regression) method. The results indicate a better five-year survival among younger-onset patients compared with older-onset patients, particularly among early-stage cancer. In the multivariable analyses, treatment refusal was associated with higher mortality risk. Furthermore, our results suggested that patients of older age at diagnosis, female gender, with comorbid conditions, and uninsured status were more likely to refuse recommended lung cancer treatment. In this dissertation, we could not analyze other relevant factors, such as types of comorbidity, patient’s performance status, treatment side effects, family history of lung cancer, and cost of treatment, due to data limitation. Adjusting such factors in future studies will provide a more robust comparison of survival and genetic differences between younger- and older-onset lung cancer cases. Future studies should also examine patients’ and clinical aspects of cancer education and patient–physician communication materials to improve patient acceptance of lung cancer treatment.
Author: Poppy E. Deviany Publisher: ISBN: Category : Languages : en Pages : 106
Book Description
Lung cancer is the second most commonly diagnosed cancer and the leading cause of cancer mortality of both genders in the United States. A recent report suggests that the relative five-year survival rate of lung cancer is only 18%. Studies indicate many factors are associated with the survival of lung cancer patients, including age at diagnosis. It is widely known as a disease of older people, but the literature shows a substantial number of young people have been diagnosed with lung cancer. The literature also indicates that the refusal of recommended treatment contributes to cancer-related death and poorer survival. The objectives of this dissertation were to estimate the survival of lung cancer patients, examine the effect of treatment refusal on survival, and investigate factors associated with treatment refusal. To address these objectives, we conducted our analyses using two large cancer databases: the Veterans Affairs Central Cancer Registry and the National Cancer Database. We performed statistical data analyses using logistic regression, the Kaplan–Meier survival estimator, and Cox regression (proportional hazards regression) method. The results indicate a better five-year survival among younger-onset patients compared with older-onset patients, particularly among early-stage cancer. In the multivariable analyses, treatment refusal was associated with higher mortality risk. Furthermore, our results suggested that patients of older age at diagnosis, female gender, with comorbid conditions, and uninsured status were more likely to refuse recommended lung cancer treatment. In this dissertation, we could not analyze other relevant factors, such as types of comorbidity, patient’s performance status, treatment side effects, family history of lung cancer, and cost of treatment, due to data limitation. Adjusting such factors in future studies will provide a more robust comparison of survival and genetic differences between younger- and older-onset lung cancer cases. Future studies should also examine patients’ and clinical aspects of cancer education and patient–physician communication materials to improve patient acceptance of lung cancer treatment.
Author: Kok-Yang Tan Publisher: Springer Science & Business Media ISBN: 3642298834 Category : Medical Languages : en Pages : 207
Book Description
As the population ages, clinicians are facing an increasing number of elderly patients with colorectal cancer. These patients pose unique challenges as they have more comorbidities and lower functional reserves. In addition, the treatment goals may differ from those in younger patients. This book discusses in depth the different aspects of management of colorectal cancer in the elderly. After the provision of pertinent background information on the normal physiology of aging, screening and diagnosis are discussed. Subsequent chapters focus on a range of issues associated with the surgical and perioperative care of these patients and with adjuvant treatment and palliative care. Each chapter provides helpful take-home messages in bullet point form, and numerous informative figures and tables are also included. The authors are surgeons, physicians, anesthetists, geriatricians, oncologists, and allied health professionals with extensive experience in the field.
Author: Agency for Healthcare Research and Quality/AHRQ Publisher: Government Printing Office ISBN: 1587634333 Category : Medical Languages : en Pages : 385
Book Description
This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.
Author: National Research Council Publisher: National Academies Press ISBN: 0309255716 Category : Medical Languages : en Pages : 424
Book Description
In the late 1980s, the National Cancer Institute initiated an investigation of cancer risks in populations near 52 commercial nuclear power plants and 10 Department of Energy nuclear facilities (including research and nuclear weapons production facilities and one reprocessing plant) in the United States. The results of the NCI investigation were used a primary resource for communicating with the public about the cancer risks near the nuclear facilities. However, this study is now over 20 years old. The U.S. Nuclear Regulatory Commission requested that the National Academy of Sciences provide an updated assessment of cancer risks in populations near USNRC-licensed nuclear facilities that utilize or process uranium for the production of electricity. Analysis of Cancer Risks in Populations near Nuclear Facilities: Phase 1 focuses on identifying scientifically sound approaches for carrying out an assessment of cancer risks associated with living near a nuclear facility, judgments about the strengths and weaknesses of various statistical power, ability to assess potential confounding factors, possible biases, and required effort. The results from this Phase 1 study will be used to inform the design of cancer risk assessment, which will be carried out in Phase 2. This report is beneficial for the general public, communities near nuclear facilities, stakeholders, healthcare providers, policy makers, state and local officials, community leaders, and the media.
Author: Ole Møller Jensen Publisher: IARC ISBN: 9283211952 Category : Medical Languages : en Pages : 295
Book Description
Data obtained by population based cancer registries have a pivotal role in cancer control. Now also available in Spanish and French, this volume, which contains 15 authored chapters and four useful appendices, remains a standard reference for those planning to establish new cancer registries and those keen to adopt recognized methodologies. Information is given on the techniques required to collect, store, analyse and interpret data.
Author: National Academies of Sciences, Engineering, and Medicine Publisher: National Academies Press ISBN: 0309377722 Category : Medical Languages : en Pages : 473
Book Description
Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.
Author: Institute of Medicine Publisher: National Academies Press ISBN: 0309157870 Category : Medical Languages : en Pages : 317
Book Description
The National Cancer Institute's (NCI) Clinical Trials Cooperative Group Program has played a key role in developing new and improved cancer therapies. However, the program is falling short of its potential, and the IOM recommends changes that aim to transform the Cooperative Group Program into a dynamic system that efficiently responds to emerging scientific knowledge; involves broad cooperation of stakeholders; and leverages evolving technologies to provide high-quality, practice-changing research.
Author: Nobutoshi Ando Publisher: Springer ISBN: 4431549773 Category : Medical Languages : en Pages : 313
Book Description
Esophageal cancer causes an estimated 386,000 deaths worldwide and is the sixth most common cause of death for men. The background characteristics of esophageal cancer treatment are markedly different between Asian and Western countries, however. In tumor histology, squamous cell carcinoma associated with smoking and alcohol consumption is overwhelmingly prevalent in Asia, whereas adenocarcinoma associated with Barrett’s metaplasia is markedly prevalent in the West. In Asia, especially in Japan, the key persons who play important roles in the management of esophageal cancer patients are surgeons; in the West those roles are filled by medical and radiation oncologists as well as surgeons. The philosophy of surgeons regarding cancer surgery varies from locoregional to local tumor control, particularly in focusing on lymph node dissection. Physicians’ approach to surgical adjuvant therapy differs, therefore, between Asia and the West. Considering these East–West differences in esophageal cancer treatment, the currently available results of Western evidence should not be considered directly applicable to esophageal cancer in Asia. In this book, the authors discuss the knowledge base in Japan in terms of treatment of esophageal squamous cell carcinoma. Since this volume contains a wide spectrum of current information and addresses topics surrounding the treatment of patients with esophageal squamous cell carcinoma, it is highly relevant to Asian physicians and researchers as well as to their counterparts in the West.
Author: Ronald Ross Watson Publisher: CABI ISBN: 184593413X Category : Medical Languages : en Pages : 937
Book Description
The potential benefits of plants and plant extracts in the treatment and possible prevention of many leading health concerns are historically well known and are becoming more widely studied and recognized within the medical community. It is these studies that led to the first compilation of new research developments, identifying new extracts and uses for plants in disease prevention and treatment. This major comprehensive reference work contains contributions from more than 150 clinical and academic experts covering topics such as treatments of cancer and cardiovascular diseases, as well as historical plant use by indigenous people supported by recent scientific studies. Authors review the safety and efficacy of botanical treatments while idenifying the sources, historical supportive data and mechanisms of action for emerging treatments. Written by researchers currently carrying out identification and biomedical testing, this is the most up to date text on the latest research from all over the world. It is an essential resource for health care practitioners and herbalists, as well as researcher, students and professionals in botany and alternative medicine.
Author: Leonard L. Gunderson, MD, MS, FASTRO Publisher: Elsevier Health Sciences ISBN: 0323240984 Category : Medical Languages : en Pages : 2253
Book Description
Perfect for radiation oncology physicians and residents needing a multidisciplinary, treatment-focused resource, this updated edition continues to provide the latest knowledge in this consistently growing field. Not only will you broaden your understanding of the basic biology of disease processes, you'll also access updated treatment algorithms, information on techniques, and state-of-the-art modalities. The consistent and concise format provides just the right amount of information, making Clinical Radiation Oncology a welcome resource for use by the entire radiation oncology team. Content is templated and divided into three sections -- Scientific Foundations of Radiation Oncology, Techniques and Modalities, and Disease Sites - for quick access to information. Disease Sites chapters summarize the most important issues on the opening page and include a full-color format, liberal use of tables and figures, a closing section with a discussion of controversies and problems, and a treatment algorithm that reflects the treatment approach of the authors. Chapters have been edited for scientific accuracy, organization, format, and adequacy of outcome data (such as disease control, survival, and treatment tolerance). Allows you to examine the therapeutic management of specific disease sites based on single-modality and combined-modality approaches. Features an emphasis on providing workup and treatment algorithms for each major disease process, as well as the coverage of molecular biology and its relevance to individual diseases. Two new chapters provide an increased emphasis on stereotactic radiosurgery (SRS) and stereotactic body irradiation (SBRT). New Associate Editor, Dr. Andrea Ng, offers her unique perspectives to the Lymphoma and Hematologic Malignancies section. Key Points are summarized at the beginning of each disease-site chapter, mirroring the template headings and highlighting essential information and outcomes. Treatment algorithms and techniques, together with discussions of controversies and problems, reflect the treatment approaches employed by the authors. Disease Site Overviews allow each section editor to give a unique perspective on important issues, while online updates to Disease Site chapters ensure your knowledge is current. Disease Site chapters feature updated information on disease management and outcomes. Four videos accessible on Expert Consult include Intraoperative Irradiation, Prostate Brachytherapy, Penile Brachytherapy, and Ocular Melanoma. Thirty all-new anatomy drawings increase your visual understanding. Expert Consult eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, and references from the book on a variety of devices.
Author: Poppy E. Deviany
Author: Poppy E. Deviany
Author: Kok-Yang Tan
Author: Agency for Healthcare Research and Quality/AHRQ
Author: National Research Council
Author: Ole Møller Jensen
Author: National Academies of Sciences, Engineering, and Medicine
Author: Institute of Medicine
Author: Nobutoshi Ando
Author: Ronald Ross Watson
Author: Leonard L. Gunderson, MD, MS, FASTRO